Central Carolina Hospital is seeking state approval for a $14 million expansion of its Emergency Department, including its emergency room.

CCH submitted an application in mid-February to the N.C. Department of Health and Human Services and must comply with North Carolina's Certificate of Need law — a policy requiring health care providers to show need prior to replacing or adding facilities — before it can expand. Under a proposed time line in the hospital's application, the expansion would tentatively be completed in fall 2016.

The project requires a full review by the state to determine whether there is a significant need based on the data submitted by CCH, said hospital CEO Doug Doris.

"I don't think we should have any problems getting approved," he said. "We have a huge amount of need. I have been here for about six years, and in that time, the number of (emergency room) visits grew from 27,000 per year to 41,000 per year. We just haven't gotten enough rooms."

The number of emergency room visits has increased by 30 percent in the last four years and, with an increasingly aging population, the numbers are expected to grow at a steady rate, according to the application.

The expansion would increase the number of emergency treatment areas from 15 to 24 and add close to 12,500 square feet plus renovations to the existing 9,500 square feet, according to the hospital's application. The Emergency Department would see an improved patient monitoring system, add clean and dirty supply rooms, improve patient treatment and holding areas and add a "Fast Track treatment area for less acute patients."

"The newly expanded ED will provide for improved patient flow as the configuration will allow for separation of the fast-track patients as well as a discharge unit to expedite the process," the application states. "Additionally, the project will improve patient safety and limit liability by providing equipped psychiatric safe rooms which are not currently available."

The Emergency Department now has too few exam rooms for the number of visits, inadequate space throughout the department for staff workspace, a lack of storage space for EMS and equipment, an inadequate number of toilets for staff and the public and a lack of specialty patient care areas — all of which are listed as current facility constraints in the hospital's application.

The construction of the expansion would be completed in three phases while maintaining the same number of available rooms in the emergency room, and Doris said he'd like to begin the process as soon as the hospital is approved. Construction could begin as early as 2014 and is estimated to cost $13 million. An additional $1 million would be needed for supplies and equipment.

The state has anywhere from 90 to 150 days to review an application after it has been submitted.